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Fenoldopam and N ‐acetylcysteine for the Prevention of Radiographic Contrast Material—Induced Nephropathy: A Review
Author(s) -
Walker Paul D.,
Brokering Kristi L.,
Theobald John C.
Publication year - 2003
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.23.15.1617.31958
Subject(s) - fenoldopam , acetylcysteine , medicine , nephropathy , nomogram , contrast (vision) , prospective cohort study , intensive care medicine , urology , pediatrics , endocrinology , chemistry , dopamine , computer science , dopamine receptor , biochemistry , artificial intelligence , diabetes mellitus , antioxidant
Radiographic contrast material‐induced nephropathy (RCIN) is the third most common cause of hospital‐acquired renal insufficiency and has been associated with an increase in patient mortality. Many strategies to prevent RCIN have been explored unsuccessfully. The standard of care remains hydration with 0.45% sodium chloride before and after administration of contrast material. Recently, N ‐acetylcysteine and fenoldopam have been studied to determine their efficacy in preventing RCIN. Of seven prospective studies using various dosing regimens of N ‐acetylcysteine, four revealed beneficial results. Although some discrepancies exist, the data strongly suggest that N ‐acetylcysteine has a role in patients at risk for the development of RCIN. The data for fenoldopam are more limited, with only one retrospective study showing benefit. Additional prospective data are required to determine if fenoldopam has a role in the prevention of RCIN.